Worried! What happens at a one-stop breast clinic?

If you have noticed symptoms of breast cancer, such as a lump or changes in or around your breasts, it is natural to be concerned. Many women go to a one-stop breast clinic for a quick and reassuring diagnosis; but if it's your first time, you may not know what to expect and feel anxious about the tests you'll have to undergo.

Mr Simon Smith, a top breast and endocrine surgeon explains what happens at these clinics, the types of tests used and how long you need to wait for your results.

What is a one-stop breast clinic?

A one-stop breast clinic is a service in which patients who have concerning breast symptoms such  as a lump, breast pain, nipple discharge or skin changes, can be seen in an outpatient clinic to receive an immediate and accurate diagnosis within a few hours. The key feature is that the consultation and tests all occur on a single visit, so you do not have to worry waiting for results.

What symptoms do women usually go in for?

Women present to a one-stop breast clinic because they have noticed a lump, pain and/or a structural change in one of their breasts. The main symptoms women notice are:

• Lump in the breast
• Change in the shape of their breast
• Changes in the nipple
• Tethering of the nipple (visible dimple)
• Discharge from the nipple
• Pain in the breast

Many women come in with breast pain, but unless there is a structural change, it is very rarely cancer. It is thought that about 70% of women experience breast pain at some point in their lives, but breast pain alone is rarely due to cancer.

What happens when you go to a one-stop breast clinic?

When you come to a one-stop breast clinic, you will first have a consultation and clinical examination by a surgeon. You will then undergo the appropriate radiological examination, which may include a mammogram and ultrasound scan. All of the tests required at the one stop breast clinic are usually covered by most health insurance plans. The results of the mammograms and/or ultrasound are available immediately at the one-stop clinic.

Sometimes people with a solid lump require a needle biopsy; although the biopsy is usually undertaken at the time of the other tests, the results are often not available for up to a week.

At our breast clinic, we can offer a self-pay package price so you can still access the one-stop breast clinic even of you are not insured; the package price means you know what it will cost before you start.

After your examination with the surgeon and any necessary investigations, you will be offered follow-up care if needed. Most people are discharged after the first visit, but some people need follow-up care not only for cancer, but also for other conditions found, such as abscesses or cysts. Fortunately, few are diagnosed with cancer.

What happens if cancer is found?

Since there are many different types of breast cancer, we must wait for the results before we can make a treatment plan. As mentioned earlier, results can take up to a week. Treatment usually consists of a combination of surgery, chemotherapy, and/or hormone therapy.

Your treatment plan will be customised and created by a multidisciplinary team of surgeons, oncologists, radiologists and nurses. Our approach is never a one-solution-fits-all approach. The patient will come back, talk about the tumour and then we can recommend the right treatment.

How has COVID-19 impacted breast cancer treatment?

COVID-19 has had a huge impact on it. In the first wave, NHS services and private clinics were completely shut down. Any woman with a lump in her breast should always be seen within two weeks, but the health service massively failed to do this with waiting times of up to six weeks at the height of the pandemic.

Fortunately, our one-stop breast service has been able to continue throughout. Many private hospitals are unable to offer surgery for the time being, but we are lucky enough to be able to operate throughout the pandemic.

What COVID-19 safety measures are in place at the hospital?

Everyone who needs surgery must first have a COVID-19 PCR test with a negative result. The clinic is always socially distant by avoiding too many people coming at once. If you really need support, you can bring a friend, but we can ask you to avoid this if you can.

The measures we take enable us to run a full reconstructive breast surgery service and, above all, we want to ensure that we can continue to do so.

How can women get an appointment at a one stop breast clinic?

I run clinics twice a week and any woman can come to the next consultation. They can self-refer (depending on their insurance) or they can be referred by their GP.

You can call my office at any time to get an appointment for the next clinic on 01245 234477 – the clinic is always open!

We don't have a limit on numbers on clinic, so ladies often book in at the very last minute. This means there is sometimes a bit of a backlog, but I see everyone who wants to be seen on the day… eventually!

Mr Simon Smith is a highly qualified specialist breast and endocrine surgeon based in Chelmsford. Head to his Top Doctors profile to book an appointment.